초록접수 현황
| 21F-211 | 구연 발표 |
Outcomes of surgical anastomosis sequence modification to minimize warm ischemic time in the orthotopic heart transplantation using bicaval technique
Eunji Kim, Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : The longer ischemic time is an important risk factor for primary graft dysfunction, so there are many kinds of methods for effective organ preservation techniques. The present study was performed to know the clinical outcomes of surgical anastomosis sequence modification to minimize the warm ischemic time.
Methods : Between March 2009 and December 2020, a total of 283 patients who underwent orthotopic heart transplantation by a single surgeon were enrolled in the study. The conventional anastomosis sequential technique (C-group) was performed in 102 patients and the modified anastomosis sequential technique (M-group) was performed in 181 patients. In this modification, the aorta cross-clamp (ACC) was released just after the left atrium and aorta anastomosis as possible and remained anastomosis was done under the beating heart state.
Results : The mean recipient age was 50.1 ± 13.2 years in C-group and 52.1 ± 12.7 years in M-group (p=0.226). There were more preoperative chronic kidney disease and hemodialysis patients in M-group (N=32, 17.7% and N=41, 22.7%) than C-group (N=7, 6.9% and N=8, 7.8%). The numbers of status 0 patients in M-group (N=63. 34.8%) were more than that of C-group (N=10, 9.8%) (p<0.001). There were significant differences in mean warm ischemic time that was 59.8 ± 14.4 minutes in C-group and 35.2 ± 8.9 minutes in M-group, respectively (p<0.001). However, there were no significant differences in postoperative outcomes.
Conclusion : There were no significant differences in postoperative outcomes, however, considering the preoperative conditions, the modified sequential anastomosis could be an effective and safe method in heart transplantation.
Methods : Between March 2009 and December 2020, a total of 283 patients who underwent orthotopic heart transplantation by a single surgeon were enrolled in the study. The conventional anastomosis sequential technique (C-group) was performed in 102 patients and the modified anastomosis sequential technique (M-group) was performed in 181 patients. In this modification, the aorta cross-clamp (ACC) was released just after the left atrium and aorta anastomosis as possible and remained anastomosis was done under the beating heart state.
Results : The mean recipient age was 50.1 ± 13.2 years in C-group and 52.1 ± 12.7 years in M-group (p=0.226). There were more preoperative chronic kidney disease and hemodialysis patients in M-group (N=32, 17.7% and N=41, 22.7%) than C-group (N=7, 6.9% and N=8, 7.8%). The numbers of status 0 patients in M-group (N=63. 34.8%) were more than that of C-group (N=10, 9.8%) (p<0.001). There were significant differences in mean warm ischemic time that was 59.8 ± 14.4 minutes in C-group and 35.2 ± 8.9 minutes in M-group, respectively (p<0.001). However, there were no significant differences in postoperative outcomes.
Conclusion : There were no significant differences in postoperative outcomes, however, considering the preoperative conditions, the modified sequential anastomosis could be an effective and safe method in heart transplantation.
책임저자: Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Eunji Kim, E-mail : kej2683@gmail.com